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Background. While rapid early weight gain are common in children who become obese later in life, so is growth faltering in the first 3 months of life. Objective. We seek to determine what relationship weight gain in the first six months of age, separated into two 3-month periods, have with the BMI of children ages 4 to 6 years in an inner-city community. Subjects. A convenience sample cohort of 154 children attending an inner-city clinic. Methods. Consecutive charts were reviewed retrospectively. Age, gender, birth weight and weight change in the first and second 3 months of life were introduced as fixed factors using mixed linear models with BMI in years 4 to 6 as the dependent variable. Results. Weight change quartile in the first 3 months of life did not predict of BMI in years 4 to 6; however, weight changes quartiles during months 4 to 6 were significant predictors for subsequent overweight. Conclusion. The data presented herein suggest that, for this specific population, weight gain can be promoted when it is most essential. It is necessary, however, to identify intermediary variables that could affect outcomes in this and other communities.

Undernutrition--protein energy malnutrition or specific nutrient deficiencies--has been an inherent characteristic of impoverished populations throughout the world. Over-nutrition, obesity and nutrition imbalance is a current concern among those with rising though still insufficient incomes. We review data to suggest that the prevalence of these forms of malnutrition in populations is highly influenced by the rate of appearance of discretionary income. In developed countries, discretionary (alternatively "disposable") income refers to funds available after obligate payments (rent, heat, and the cost of getting to work) and payment for necessities (food and clothing). For families living at or below poverty, the last dollar earned is spent on these obligations. Undernutrition is common. By contrast, likelihood for obesity or imbalance increases with rising income when that last dollar is earned without certainty that it is available for discretionary spending. In the United States, neither under- nor over-nutrition is likely when new income is free and clear of debt or obligation. This occurs at approximately three times the poverty level. While income poverty and food insecurity affect risk for malnutrition rather than outcome, nutrition education programs that address issues of income and food support increase likelihood for adherence to recommendations.

In a survey of black inner-city school children 10 to 13 years of age, a significant correlation was found for obesity index (weight/height(2)) and measurements of systolic blood pressure. Significant correlations were found for both blood pressure and obesity index of mothers and daughters. No such relationships were found for mothers and sons. There was an increased availability of sodium-rich foods found for girls as their age increased. This was not found for boys.Both obesity and a sodium-rich diet are risk factors for the development of hypertension. The present study suggests that among over-weight black girls in the preteen years, attempts should be made (1) to identify (and limit) any increase in the consumption of salty foods and (2) to limit weight gain appropriately.

In a hematologic survey conducted in 1972, microcythemia in school children was found to be associated with microcythemia in other family members. The association of cultural characteristics of chronic poverty with reduced red cell volume suggested nutritional iron deficiency. A resurvey of families was made in 1975. For 39 children between the ages of 3 and 10 years at the time of both surveys, mean hemoglobin concentration (HGB) decreased from 21.0 g/dl to 10.8 g/dl. Thirteen infants, 6 months to 3 years of age in 1972, in the resurveyed families had mean HGB of 11.5 g/dl as compared to 10.4 g/dl for 9 similarly aged children newly born into the resurvey families. The rate of somatic growth was unchanged during the interval between survey. During the interval between 1972 and 1975, food costs rose nationally, and the purchase of meat products decreased both nationally and (as found in this study) locally. The data suggest that the high cost of foods rich in micronutrients may increase the prevalence of iron deficiency in an impoverished community.

This study was designed to identify differences in parental behaviors and the availability of food between undernourished and well-nourished inner-city children of early school age. Children with a constellation of measurements of height below the 25th percentile, midarm muscle circumference below the 50th percentile, and hemoglobin concentration below 11.5 g/dL were considered undernourished. These children were matched with controls having measurements above these levels. The homes of all children were investigated. Families of undernourished children were found to have significantly less variety of nutritious foods requiring preparation by an adult available in the home (P less than .01), to have greater variety of convenience foods of low nutritional value (P less than .01), and to prefer fewer vegetables (P less than .04) and dairy products (P less than .01). The Polansky Child Level of Living Scale showed that mothers of undernourished children were less likely to prepare meals regularly for their children (P less than .05) and that they were less effective in providing general parental support to their children (P less than .03).

The authors performed a case-control study of 60 school children who were examined for a constellation of anomalies suggestive of fetal alcohol exposure. Nonretarded learning disabled children were 7.25 times (95%, confidence interval, 1.05 to 50.0) more likely than controls to have signs consistent with alcohol exposure in fetal life. These data suggest an expanded spectrum of fetal alcohol effects. Early recognition of minor physical anomalies could result in prompt evaluation and treatment of these children.

The growth and nutritional status of 2,056 schoolchildren from a poor community in southern New Jersey were assessed. Age-adjusted differences in growth among black, white, and Hispanic children were examined. Black youths were 2.5 centimeters (cm) taller (P less than .001) and 0.9 kilograms (kg) heavier than white youths (P less than .05). Black girls were 4.1 cm taller (P less than .001) and 2.8 kg heavier than white girls (P less than .01). Hispanic girls were 1 kg heavier (P less than .05) and 0.9 cm taller (not significant) than white girls. There was little difference in growth between Hispanic and white youths. Children were assessed with the use of the Centers for Disease Control's nutritional surveillance cutpoints; less than 5 percent of each ethnic group fell below the fifth percentile, according to the National Center for Health Statistics' weight-for-height standards. White and Hispanic youths were twice as likely as blacks to fall below the 5th percentile for stature or to be overweight (above the 95th percentile for weight-for-height). Compared with black girls, white and Hispanic girls were three to four times more likely to fall below the fifth percentile for stature. The prevalence of short stature was also higher among white girls (15.9 percent) compared with Hispanics (10.3 percent). There was little difference in the prevalence of overweight by ethnic group for girls. These data show that white children from poor communities have decreased growth and suggest that they may be at increased risk of nutritional problems.